Trama Patient Assessment and Managment - EMTB Practical Skill Review - 05

[bluealkaline87]

Student here. Do you ever use a OPA on a conscious patient?

[hotroderguy]

@bluealkaline87 i can't say never, but never. I mean you would have to have a patient with no gag reflex, which isn't impossible, but highly unlikely. because you've got to remember the OPA is for keeping tongue from sliding down and blocking your airway. most conscious patients have that ability. And I do use the word "most" there's always exceptions to most everything.

[AloneIBreak86]

He didn't care for shock m'kay...

[JohnNEXT]

Shouldn't you voice checking for trachal devation, JVD and steps inthe spine upon postior exam?

[nhiphammm]

so i take it the diagnosis for this patient would be a pnemothorax?

[Erick8869]

so OPQRST is meant if the patient is in pain correct ? and DCAPBTLS is only for trauma patients right ?

[hotroderguy]

@Erick8869 yes and no, I mean if you have time for a detail exam of a trauma patient then you could use OPQRST to be document a femur fraction or something, a lot of procedures you follow are very fluid

[MadDogW1]

Never in my class did I see a "-" in DCAPBTLS. Plus, the lady should tell the guy before he takes a pulse or feels for damage, what the pulse reading or the heart rate is and if there are injuries because, obviously the guy lying down, who is just there for training purposes, is going to not have any true injuries or fake readings.

[kmed88714]

He never told the assistant rescuer to let go of c-spine so he's still awarded the point, beemer. What I would have critiqued was getting the pt off the ground, into my truck bc the scene can still become unsafe (it wouldn't obviously Bc of testing purposes) plus it's an ALS Call due to the MOI so he should have transported after he determined his ABCs. The wound is life threatening...

[beemer540ia]

Did not measure and place cervical collar!

[Soothfish]

They didn't check the guy's head. Whenever someone falls down you have to assume possible head injury.

[3cheers4Ger]

Hey, when the EMT guy has the stethoscope on, is he listening to heartbeat or lungs? Cuz my bio textbook says it's the heart valves opening and closing..

[hotroderguy]

@3cheers4Ger the only time I saw the stethoscope out was when he was taking the patients BP. what time in the video are you referring to?

[ParkerHipHop]

@hotroderguy You're right, he was taking blood pressure using the brachial artery; I don't know why I had the hemo/pneumo thing in my head lol.. He should have done that for a penetrating trauma though, that's probably why I wrote that comment at the time.

[kikomagana1990]

@hotroderguy at the very very beginning of the video you see the EMT putting the stethoscope on the patient's chest.

[Soothfish]

@3cheers4Ger Lungs

There usually isn't any need to check heart sounds pre-hospital but sometimes they'll check for a murmur.

[3cheers4Ger]

@Soothfish I see. When is it necessary to check heart sounds? Is it when the patient is unconscious?

[Soothfish]

@3cheers4Ger They can be conscious. They might be having chest pain and they tell you about their history of heart murmur. If the murmur has changed then this could be important information. The murmur itself is generally harmless unless the heart valves are deteriorating rapidly.

[3cheers4Ger]

@Soothfish A heart murmur is when blood leaks past the valves,right? I'm still new to this stuff...

[Soothfish]

@3cheers4Ger Yes. The valve closes most of the way but leaves a small opening for back flow.

[Soothfish]

@3cheers4Ger oops I almost forgot. Another time you want to check for heart sounds is when there is suspected cardiac (pericardial) tamponade. This is when fluid accumulates in the cardiac tissue usually due to penetrating/blunt trauma to the coronary arteries or veins.

You listen for 'muffled' heart sounds.

[Soothfish]

@3cheers4Ger for example, a myocardial infarction (heart attack) could be killing the tissue responsible for closing the tricuspid valve. The result would be the murmur turning into complete back flow into the right atrium.

That would be REALLY bad.

[Pimble1865]

@3cheers4Ger We only use the (EARS) AKA stethoscope for lung sounds and BP, when dealing with the heart/circulation, use ECG so you can check the P,Q,R,S complex/rhythm.

[3cheers4Ger]

@Pimble1865 What is PQRS?

[TheTreasured1]

@3cheers4Ger If the patient is having respiratory problems OPQRST is an acronym that is used to remember what questions to ask the patient. Onset, (when did the symptoms start?) Provocation, (does anything make it better or worse?) Quality (what does it feel like? stabbing, dull cramping,etc) Radiates (does it move to any other part of your body?) Severity (on a scale of 1-10, with 10 being the worse pain you have ever felt, can you rate it for me? Time (How long have you had these symptoms?)

[3cheers4Ger]

@TheTreasured1 Thank you. :D

[k92392]

@3cheers4Ger In the beginning of the video the EMT was checking for lung sounds.

[ParkerHipHop]

@3cheers4Ger He's checking lung sounds to confirm the presence (or lack-there-of) of a pneumo/hemo thorax.

[3cheers4Ger]

@ParkerHipHop Thanks.

[3cheers4Ger]

Do people have to do assessments like this in a volunteer ambulance? I'm 16 and I want to join the volunteer ambulance for my town.

[hotroderguy]

@3cheers4Ger Hi! Yes they do, any EMT or Paramedic does an assessment. It's the foundation to what we call Emergency or PreHospital Medicine. An assessment is how you figure out what to treat, what is life threating and how to treat whatever it is

[champlinparkhs]

@3cheers4Ger You can join a volunteer ambulance in your town? I have to wait util I'm 18.... I guess some of the laws are different.

And yes, you would have to do an assessment like this in order to do this job =)

[3cheers4Ger]

@champlinparkhs Yup. 16 is the minimal age requirement to volunteer in my town. It's a small town in Jersey. Anyway, my friend got me an application from the ambulance, and she's gonna give it to me tomorrow in school.

I'm pretty nervous, but...I'll be allright. :) I just gotta be positive.

[champlinparkhs]

@3cheers4Ger Wow! Thats cool, I am going through my first responder class right now in minnesota and just passed my cpr test today =) Next year I'll be taking an EMT class, so I'm excited for that.

Thats the right attitude to have about it =) I am sure you will do well

Good luck !

[3cheers4Ger]

@champlinparkhs Thanks. :D Good luck to you too. Is the CPR test easy? My friend's giving me the application tomorrow cuz she forgot it at her house again...;_; Anyway.......YAYYYYYYYYY

[champlinparkhs]

@3cheers4Ger Thanks! I passed my cpr test! It was easy, all you would have to know is the stuff you have been taught and you will do fine. But don't get to nervous, because thats what I did and I got tense, but once I got to the situation I was fine.

I hope you do well =)

[Soothfish]

@3cheers4Ger You do assessments like this in an EMT basic class.

[84jessaud]

you to go thru a first responder course not as much training as a EMT

[pgr825]

Great!